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Evidence of impaired neurocognitive functioning in school-age children awaiting cardiac surgery
Rachel van der Rijken1, Gerdine Hulstijn-Dirkmaat, Floris Kraaimaat
1Department of Medical Psychology, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands. r.vanderrijken@mps.umcn.nl
Insights
Children with congenital heart disease (CHD) experience neurocognitive deficits, including impaired motor planning and visual memory, even before undergoing cardiac surgery. These challenges highlight pre-existing issues related to the condition itself.
Area of Science:
- Pediatric Cardiology
- Neurodevelopmental Disorders
- Congenital Heart Disease
Background:
- Children with congenital heart disease (CHD) are known to be at risk for neurocognitive deficits.
- The timing of these deficits, whether pre-existing or post-surgical, remains unclear.
Purpose of the Study:
- To investigate the presence of neurocognitive deficits in children with CHD prior to cardiac surgery.
- To determine if identified deficits are a consequence of the disease itself rather than surgical intervention.
Main Methods:
- A comparative study involving 45 children with CHD and 41 healthy controls.
- Assessment of neurocognitive functions including attention, processing speed, motor skills, and visual memory.
- Analysis of patients awaiting initial or follow-up cardiac surgeries.
Main Results:
- Children with CHD demonstrated significant neurocognitive impairments compared to healthy peers.
- Deficits were specifically noted in motor planning (p=0.02) and visual memory (p=0.01).
- Similar neurocognitive profiles were observed in children awaiting their first cardiac surgery.
Conclusions:
- School-age children with CHD exhibit neurocognitive impairments before undergoing cardiac surgery.
- These findings suggest that neurocognitive deficits are associated with CHD itself, preceding surgical treatment.
Aim:
Children with congenital heart disease (CHD) are at risk of developing neurocognitive problems. However, as these problems are usually identified after cardiac surgery, it is unclear whether they resulted from the surgery or whether they pre-existed and hence might be explained by complications and events associated with the heart disease itself. The purpose of this study was to examine whether neurocognitive deficits commonly reported after cardiac surgery are present before surgery.
Method:
Forty-five children (22 males, 23 females; mean age 11 y 6 mo, SD 3 y 0 mo) with cyanotic and acyanotic heart diseases scheduled for elective cardiac surgery were compared with 41 healthy peers (17 males, 24 females; mean age 11 y 10 mo, SD 2 y 10 mo) for attention and processing speed, construction, motor speed, motor planning and fluency, and visual memory. Twenty-three children in the patient group were awaiting their first cardiac surgery and 22 were awaiting follow-up surgery.
Results:
The patients showed manifest neurocognitive difficulties. Their performance was inferior to that of the healthy comparison group for motor planning (p=0.02) and visual memory (p=0.01). The same neurocognitive profile was found in the group of patients awaiting their first cardiac operation.
Interpretation:
School-age children with various forms of CHD are at risk of neurocognitive impairments before cardiac surgery.
